Mechanism of toxicity: Metabolic acidosis and organ dysfunction primarily result from generation of glycolic and oxalic acid from metabolism of ethylene glycol The accumulation of glycolic acid is the primary cause of metabolic acidosis, but glycolate also impairs cellular respiration, and this effect can contribute to the development of lactic acidosis in some patients Acute renal failure (ARF), myocardial dysfunction, neurologic function, and possibly pulmonary dysfunction result from deposition of oxalate with calcium in the kidney, heart, brain, and lung Deposition of calcium oxalate in tissues also produces hypocalcemia, which depresses cardiac function and BP